Cardiac magnetic resonance imaging T1 mapping and late gadolinium enhancement entropy: Prognostic value in patients with systemic sclerosis

Background: Systemic sclerosis (SSc) affects the myocardium, thereby resulting in a poor prognosis. Late gadolin-ium enhancement (LGE) entropy, derived from routine cardiac magnetic resonance (CMR) LGE images, is an index that reflects the complexity of the left ventricular myocardium. The aim of this study was to investigate whether LGE entropy can serve as a prognostic factor in patients with SSc.Methods: Twenty-four patients with SSc, who underwent CMR-T1 mapping and LGE to identify myocardial dam-age, were enrolled, and LGE entropy was measured. Extracellular volume (ECV) values were calculated using the same CMR-LGE images. The endpoint was major adverse cardiac events (MACEs), comprising all-cause death, hospitalization due to heart failure, and the onset of sustained ventricular tachycardia and ventricular fibrillation. The ability to predict MACE was assessed using receiver operating characteristic (ROC) analysis, and the predict-ability of LGE entropy was analyzed using Kaplan-Meier analysis.Results: The ROC curve analysis demonstrated a cut-off value of 7.39 for MACE with LGE entropy and had a sen-sitivity and specificity of 80 % and 79 %, respectively. Patients with LGE entropy >--7.39 had a significantly higher MACE rate than those with LGE entropy <7.39 (p = 0.010). Moreover, LGE entropy >--7.39 was a poor prognostic factor in patients without elevated ECV values.Conclusions: LGE entropy can be used to predict MACE and allows for further risk stratification in addition to ECV determination.(c) 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.